Navigating Your Hospital Stay

The day after I gave birth to my daughter, Olivia, I decided to take her for a walk down the hall. Within seconds, nurses came flying at me from every direction and herded me frantically back to my room. I had unwittingly set out for my walk carrying Olivia in my arms—a huge no-no, they told me, since I could become dizzy and fall due to blood loss. Most hospitals insist that you stroll with your baby in her wheeled bassinet. Who knew?

As delivery day draws near, you're probably an expert on everything from mucus plugs to swaddling. Chances are, though, you're not as clear on what your hospital stay will be like after your baby makes her entrance. Knowing in advance can make that time a lot more enjoyable. Here's how it often plays out.

Baby's Out, Now What?

In some hospitals, unless you specify otherwise, the baby is cleaned and evaluated immediately after delivery. Many women, however, prefer to hold their babies straight from the womb. "The first hour after birth is when the baby is most awake and alert," says Joyce McKeever, R.N., nursemanager of obstetrics at Jersey Shore Medical Center in Neptune, N.J. "It's a great time to get acquainted and start breastfeeding, which helps the mom's uterus contract."

When writing your birth plan or discussing the delivery with your doctor or midwife, specify how you want that first hour to go, says Meagan Francis, a mother of four and author of The Everything Health Guide to Postpartum Care (Adams Media). "If the baby is healthy, most everything can be put off a little while to give you one-on-one time," she says. For example, you may want to delay having antibiotic drops placed in your baby's eyes—a standard postbirth procedure that can blur vision temporarily. As with all medical care, you have the right to question or refuse any treatment that doesn't sit right with you.

After you've delivered the placenta and been stitched up if you had an episiotomy or tear (or your Cesarean section is complete), many hospitals will transfer you to a postpartum room. Others offer LDRP (labor, delivery, recovery and postpartum) rooms in which you remain during your entire stay.

Video cameras are generally welcome once the baby's born, but filming the actual delivery usually is not. More and more hospitals are embracing "family-centered care," offering private postpartum rooms that include a marginally comfortable fold-out bed for your partner. Rooming-in, or having your baby with you at all times, is also increasingly popular; and in some hospitals, it's obligatory.

While this practice provides a nice opportunity to bond with your baby, it can also be relaxing to let her spend a few hours in the nursery while you sleep. If you do so, tell the nurses whether they can give your baby formula or you want her returned to you for feedings. And if you'd like to breastfeed but it's not coming easily—which is not uncommon—ask if a lactation consultant can pay you a visit. Large hospitals usually have one on staff.

At the same time that hospitals strive for coziness, they've beefed up security, so don't be surprised if a wireless tracking device is attached to your baby's ankle. "If your baby is taken too close to an exit, the doors will go into lock-down mode," McKeever explains.

During your hospital stay, you're likely to have heavy bleeding that lessens with each subsequent day, finally letting up in about six weeks. To soothe your sore vaginal and rectal area, bring witch hazel pads or homemade "ice pads," recommends Heather Cook of Calgary, Alberta, Canada. "Take super-size menstrual pads, soak them in water and put them in your freezer," she says. "You can store them in the hospital's freezer in a baggie labeled with your name."

Going Home

Many insurance plans cover a two-day hospital stay for a vaginal delivery and four days for a C-section, though some women, such as those with older children at home, negotiate an earlier discharge. However long you stay, a few things are required before you leave:

Mommy exam: The staff will make sure that you're healing properly— i.e., that bleeding is slowing and your uterus is contracting.

Baby exam: A pediatrician will examine your baby and administer a heelstick blood test, which screens for several metabolic disorders, such as phenylketonuria. Some states perform a hearing screening as well.

Skills check: They'll determine that your baby is able to breastfeed or bottle-feed successfully and that you understand how to perform basic tasks like bathing, caring for the cord stump and diapering. Some hospitals convey this kind of information in a pamphlet or TV segment.

Forms signed: You'll need to fill out a birth certificate even if you haven't named your baby yet.

Have someone take home gifts and flowers the day before you leave so that your last day is less hectic, suggests McKeever. Also, make sure your vehicle is equipped with a properly installed infant car seat that you know how to use—you don't want vexing straps and buckles to delay your happy homecoming!

Insider Tips From The Labor Nurse

2. Don't shower alone. After delivery, fainting is common and it happens most often in the shower because the hot water causes blood pressure to drop. Use the shower bench and ask your nurse, partner or friend to stand by.

3. Adopt a "no visitors" policy while breastfeeding if necessary. Some babies— and moms—need peace and privacy to learn the big job of nursing. — Jeanne Faulkner, R.N. (read her blog entries at fitpregnancy.com/blog/labornurse)

10 Must-Pack Items

You've got the camera, toiletries and a nursing nightie. You also need:

-Your birth plan/wish list

-Prepaid calling card and list of phone numbers of family and friends

-Your favorite pillow

-A headband or hair tie

-A breastfeeding pillow

-Two nursing bras

-A box of disposable breast pads

-Disposable underwear

-A loose going-home outfit for you

-A cozy going-home outfit for baby

A Homey Alternative

About 99 percent of U.S. births take place in hospitals, but about 10,000 women a year choose to deliver in a freestanding birth center. These are usually run by midwives and aim to provide a natural, minimally invasive experience, says Meagan Francis, author of The Everything Health Guide to Postpartum Care (Adams Media, 2007). They're not for women who want the option of an epidural or other anesthesia, and you'll need to check with your insurer about whether your stay will be covered.

In an emergency, you'll be transported to a hospital. Continuity of care is a major birth-center perk, says Francis. "You'll be cared for by the same few people during pregnancy, labor and postpartum," she says. You usually go home four to 12 hours after delivering, but a midwife will come to your home the next day. To explore this option further, visit birthcenters.org.